Renal artery occlusive disease affecting pediatric patients is an important but very uncommon cause of hypertension in children. Renal artery stenoses in this age group represent a wide spectrum of heterogeneous diseases, although developmental anomalies with concomitant narrowings of the…
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Fibrodysplastic disease of the renal arteries is bilateral in more than half of the patients, and involvement of the primary branches of the renal artery has been reported in as many as 40%. In most patients the fibrodysplastic lesions are…
Open renal revascularization for renovascular hypertension is being performed less often given advances in endovascular therapy. In fact, currently most renal artery bypass procedures are undertaken as part of hybrid operations accompanying endovascular interventions for aortic aneurysmal disease. Alternatives to…
The introduction of new, highly potent antihypertensive agents and percutaneous intervention has changed many attitudes regarding open surgical treatment for renovascular disease. Many physicians recommend surgical intervention for severe hypertension despite maximal medical therapy, for failures or disease patterns not…
Renal revascularization is indicated for renin-mediated hypertension and for progressive renal insufficiency secondary to renal artery arteriosclerosis. Renal artery atherosclerotic lesions account for 90% of all renal artery stenoses and are most often a manifestation of generalized atherosclerosis. Operative options…
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Anecdotal experience and many retrospective studies support the utility of renal artery stenting in carefully selected patients, yet Level 1 evidence has been lacking. Several multicenter prospective randomized studies have been conducted to determine whether renal artery stenting was superior…
Two questions arise when an arteriosclerotic renal artery stenosis is identified. First, is it a contributing factor to the patient’s hypertension or renal insufficiency? Second, if stenosis is a contributing factor and an operative intervention is deemed appropriate, is an…
Until the early 1960s, the pathophysiology and management of atherosclerotic renovascular disease focused solely on hypertension. However, current management of renal artery atherosclerosis considers the relationship between renal artery occlusive disease and renal insufficiency, a relationship recognized by the term…